• Ying Zhao, Jingjun Wu, Qinhe Zhang, Zhengyu Hua, Wenjing Qi, Nan Wang, Tao Lin, Liuji Sheng, Dahua Cui, Jinghong Liu, Qingwei Song, Xin Li, Tingfan Wu, Yan Guo, Jingjing Cui, and Ailian Liu.
• Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, China.
• J Magn Reson Imaging. 2021 Apr 1; 53 (4): 1066-1079.

BackgroundPreoperative prediction of early recurrence (ER) of hepatocellular carcinoma (HCC) plays a critical role in individualized risk stratification and further treatment guidance.PurposeTo investigate the role of radiomics analysis based on multiparametric MRI (mpMRI) for predicting ER in HCC after partial hepatectomy.Study TypeRetrospective.PopulationIn all, 113 HCC patients (ER, n = 58 vs. non-ER, n = 55), divided into training (n = 78) and validation (n = 35) cohorts.Field Strength/Sequence1.5T or 3.0T, gradient-recalled-echo in-phase T1 -weighted imaging (I-T1 WI) and opposed-phase T1 WI (O-T1 WI), fast spin-echo T2 -weighted imaging (T2 WI), spin-echo planar diffusion-weighted imaging (DWI), and gradient-recalled-echo contrast-enhanced MRI (CE-MRI).AssessmentIn all, 1146 radiomics features were extracted from each image sequence, and radiomics models based on each sequence and their combination were established via multivariate logistic regression analysis. The clinicopathologic-radiologic (CPR) model and the combined model integrating the radiomics score with the CPR risk factors were constructed. A nomogram based on the combined model was established.Statistical TestsReceiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of each model. The potential clinical usefulness was evaluated by decision curve analysis (DCA).ResultsThe radiomics model based on I-T1 WI, O-T1 WI, T2 WI, and CE-MRI sequences presented the best performance among all radiomics models with an area under the ROC curve (AUC) of 0.771 (95% confidence interval (CI): 0.598-0.894) in the validation cohort. The combined nomogram (AUC: 0.873; 95% CI: 0.756-0.989) outperformed the radiomics model and the CPR model (AUC: 0.742; 95% CI: 0.577-0.907). DCA demonstrated that the combined nomogram was clinically useful.Data ConclusionThe mpMRI-based radiomics analysis has potential to predict ER of HCC patients after hepatectomy, which could enhance risk stratification and provide support for individualized treatment planning.Evidence Level4.Technical EfficacyStage 4.© 2020 International Society for Magnetic Resonance in Medicine.

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